Uma S Nair1, Ryan C Reikowsky1, Betsy C Wertheim2, Cynthia A Thomson1, Judith S Gordon3. 1. 1 Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. 2. 2 University of Arizona Cancer Center, Tucson, AZ, USA. 3. 3 College of Nursing, University of Arizona, Tucson, AZ, USA.
Abstract
PURPOSE: To investigate how mode of entry into a quitline influences program utilization and quit outcomes among clients seeking cessation services. DESIGN: This is a retrospective analysis of clients receiving quitline services from January 2011 to June 2016. SETTING: The study was conducted at the Arizona Smokers' Helpline. PARTICIPANTS: Enrolled clients completed a 7-month follow-up (N = 18 650). MEASURES: The independent variable was referral mode of entry (ie, proactive, passive, and self-referral). Outcome variables included tobacco cessation medication use, number of coaching sessions completed, and 30-day tobacco abstinence at 7 months. ANALYSIS: Logistic regression was used to analyze tobacco abstinence after controlling for potential confounders. RESULTS: Compared to self-referred clients, proactively referred clients were least likely (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.81-0.97), whereas passively referred clients were most likely (OR: 1.14; 95% CI: 1.00-1.30) to report tobacco abstinence. Proactively referred (OR: 0.79; 95% CI: 0.70-0.88), but not passively referred, clients were 21% less likely to report tobacco cessation medication use than self-referred clients. CONCLUSION: Proactive referrals are associated with lower utilization of tobacco cessation medication and less successful quit outcomes; however, provider referrals are critical to reaching tobacco users who may have more significant health risks and barriers to quitting. Examining potential barriers among both providers and provider-referred clients is needed to inform improvements in training providers on brief interventions for tobacco cessation.
PURPOSE: To investigate how mode of entry into a quitline influences program utilization and quit outcomes among clients seeking cessation services. DESIGN: This is a retrospective analysis of clients receiving quitline services from January 2011 to June 2016. SETTING: The study was conducted at the Arizona Smokers' Helpline. PARTICIPANTS: Enrolled clients completed a 7-month follow-up (N = 18 650). MEASURES: The independent variable was referral mode of entry (ie, proactive, passive, and self-referral). Outcome variables included tobacco cessation medication use, number of coaching sessions completed, and 30-day tobacco abstinence at 7 months. ANALYSIS: Logistic regression was used to analyze tobacco abstinence after controlling for potential confounders. RESULTS: Compared to self-referred clients, proactively referred clients were least likely (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.81-0.97), whereas passively referred clients were most likely (OR: 1.14; 95% CI: 1.00-1.30) to report tobacco abstinence. Proactively referred (OR: 0.79; 95% CI: 0.70-0.88), but not passively referred, clients were 21% less likely to report tobacco cessation medication use than self-referred clients. CONCLUSION: Proactive referrals are associated with lower utilization of tobacco cessation medication and less successful quit outcomes; however, provider referrals are critical to reaching tobacco users who may have more significant health risks and barriers to quitting. Examining potential barriers among both providers and provider-referred clients is needed to inform improvements in training providers on brief interventions for tobacco cessation.
Entities:
Keywords:
cessation; mode of entry; provider referrals; quitline services; tobacco
Authors: Adrienne B Lent; Patrick A O'Connor; Ryan C Reikowsky; Uma S Nair; Melanie L Bell Journal: BMC Public Health Date: 2018-08-10 Impact factor: 3.295
Authors: Uma S Nair; Elizabeth S Miller; Melanie L Bell; Sharon Allen; Bradley N Collins; Alicia M Allen Journal: Contemp Clin Trials Commun Date: 2020-04-23